Core Values of Public Health Law
prevention
social justice
government
Goals of public health law
Ensure the conditions for people to be healthy
Pursue the highest possible level of physical and mental health in the population, consistent with the values of social justice
Legal tool used to promote health
Direct regulation
Indirect regulation through the tort system
Alteration of socioeconomic, built, and physical
Deregulation
Taxation and Spending
Major reasons behind the enormous gains in health
Sanitary movement
Plentiful food and leisure
Resource for everyday life, not the objective of living
Ottawa Charter for Health Promotion
Capacity for living a full and productive life
Positive health dimension
State of complete physical, mental and social well-being and not merely the absence of disease or infirmity
WHO def
Public Health Waves
Infectious disease control, extending the quality of life, chronic disease control
3 core functions of governmental public health
Assessment (public health surveillance to measure health of the population)
Policy Development (exactly how it sounds)
Assurance (assure health of population by having a competent workforce to enforce laws)
10 Essential Public Services
1.Monitor health status to identify and solve community health problems;
2.Diagnose and investigate health problems and health hazards in the community;
3.Inform, educate, and empower people about health issues;
4.Mobilize community partnerships to identi
State Public Health Labs
Network consisting of all the participants in PHL testing, including those who initiate testing and those who ultimately use the test results
Local Public Health Labs
Exist solely with the incentive, mission, and community ownership to address laboratory services for local public health and safety
Role of local PHL in supporting local public health dept. varies by the size of the community served, the relationship with
Values of a public health lab
Lab testing affects clinical decisions and provides info that aids in the prevention, diagnosis, treatment, and management of disease
Provides objective data about patient health
Hospital acquire outbreak investigations
Detecting unusual antimicrobial res
11 Core functions of Public Health
Disease prevention, control, and surveillance
Integrated data management
Reference and specialized testing
Environmental health and protection
Food safety
Laboratory improvement and regulation
Policy development
Emergency response
Public health-related re
Strategies to prevent
Antiretroviral therapy
Pre-exposure prophylaxis with daily oral tenofovir or tenofovir plus emtricitabine eff actively reduced HIV acquisition in four of six trials
Vaginal and, more recently, rectal microbicides are attractive interventions because, unli
What are the big challenges that face the development of an effective HIV vaccine?
Genetic diversity of HIV
Uncertainty about what constitutes protective immunity
Difficulty in the development an antigens that are highly immunogenic
What are the discoveries and implemented prevention strategies that helped declining the overall stage 3 (AIDS) classifications and deaths of persons with stage 3 (AIDS)?
Breakthroughs in early detection of HIV infection, improved screening technologies, advances in antiretroviral and combination drug therapies, prophylactic medications against opportunistic infections, and HIV prevention awareness campaigns
However, the p
Major biomedical evidence-based HIV prevention approaches
PrEP: The ongoing use of one or two antiretroviral medications by HIV negative individuals to prevent HIV infection
Treatment as Prevention (TasP): Evidence has shown that HIV+ persons who are on antiretroviral treatment (ART) with suppressed viral loads
ACA increasing scope of prevention
Expanded coverage access
No-cost preventative services (clinical, cessation)
Public health investments
Actions needed to reduce tobacco smoking
Enhanced surveillance to better characterize the toll of COPD
Improved systems of care to increase early detection
Improved coordination
Community based intervention focus
Research investment
Key provisions of the ACA
3205 requires CMS to reduce payments to inpatient prospective payment plans
CMS expanded applicable conditions to include patients admitted for acute exacerbation of COPD
Non-profit patient centered research (identify clinically effective treatments)
INSU
Tobacco Control Prevention Program Priority Areas
Reduce youth access to ALL tobacco products
Reduce exposure to second hand smoke
Increase access to cessation services
Media/public education campaigns
Infection
infectious agent enters a body and develops or multiplies
Infectious agents
organisms capable of producing inapparent infection or clinically manifest disease and include bacteria, parasites, and viruses.
Infectious disease
infection that results in a clinically manifest disease, may also be due to the toxic product of an infectious agent
Control of Infectious Disease
Disease actions and programs directed toward reducing disease incidence, reducing disease prevalence, or completely eradicating the disease
Pathogenicity
extent to which clinically manifest disease is produced in an infected population
ability of an organism to cause disease
Virulence
the extent to which severe disease is produced in a population with clinically manifest disease
degree of pathology caused by the organism (ability of a pathogen to multiply)
Route of Transmission
The mechanisms by which infectious agents are spread from reservoirs or sources to human hosts
Source
the person, other living organism or inanimate material from which the infectious agent came
Reservoir
Any person, other living organism, or inanimate material in which the infectious agent normally lives and grows
Horizontal Infection
Horizontal Infection: transmission
Vertical Transmission
mother to offspring
Infectious Dose
amount of pathogen (measured in number of micro-organisms) required to cause an infection in the host
Primary Prevention
Control aimed at reducing the incidence of disease
legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)
education about healthy and sa
Secondary Prevention
Control aimed at reducing the prevalence by shortening the duration of infectious disease (disease already occurred)
Regular exams and screening tests
Tertiary Prevention
Control aimed at reducing or even eliminating long-term impairments of infectious disease
cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes, arthritis, depression, etc.)
support groups that allow members to
Direct Transmission
Direct and essentially immediate transfer of infectious agents to a receptive portal of entry through which human or animal infection may take place. This may be by direct contact as touching, biting, kissing or sexual intercourse, or by the direct projec
Indirect Transmission
Contaminated inanimate objects or objects
Indirect Vector Borne Mechanical
Crawling or flying insect through the soiling of its feet, doesn't require multiplication
Indirect vector borne biological
Propagation, cyclic development or combination required before transmission
6 elements of chronic care management model for a fuller continuum of SUD
Withdrawal management,
recovery support services,
outpatient,
intensive outpatient,
short-term residential,
opioid treatment programs
Measures used to determine whether the quality of data is appropriate for surveillance purposes
� Timeliness
� Accuracy
� Completeness
� Representativeness
The objective of public health is to guarantee the health of all, regardless of ethnicity, religion, gender, sexual orientation, country, or political views
False
Ensure the conditions to be healthy
Life expectancy is increasing in
Developing and developed countries
Increasing health literacy can be considered as one of the outcomes of health protection
False
Diet and exercise are not
Biomedical interventions
Transtheoretical Model of Change
Describes five stages individuals progress through when attempting to change a health behavior
Structural interventions include
increasing tobacco taxes
Mandating a helmet law
Interventions can be applied to promote smoking cessation
Behavorial
Structural
Non-communicable diseases (NCDs) are the following medical conditions or diseases, EXCEPT
Mainly diarrheal diseases, tuberculosis, and malaria
Four major NCDs in the world include the following, EXCEPT
HYPERTENSION
Four leading risk factors for non-communicable disease deaths
High blood pressure, high blood sugar, tobacco use, physical inactivity
The four major preventable risk factors for NCDs defined by WHO are the following,
EXCEPT
Genetic susceptibility
Bump in cancer incidence
PSA screening test
Leading cause of death worldwide
cardiovascular diseases
Highest crude cancer rate
high income (cardio death rate higher in low income countries)
Epedimology is
A methodology
Core strategy of public health
One of the two main concepts of epidemiology is
agent, host, environment (time person place)
Which of the following metrics should be used to measure the spread of an epidemic?
Incidence
Point incidence
Population at risk at a single point in time
The diagnostic criteria for a disease in a surveillance system should be
Functional to use
Reasonably accurate
Population boom
1950-2000 (only region whose share of global population didn't decline was africa)
Regular health examinations and early detection of work-related health problems are examples of
Secondary prevention
Putting a "funnel lock" to prevent burns from multiple coffee makers is an example of
primary prevention
Farming food organically is an example of
primary prevention
Which region of the US has the highest prevalence of obesity (BMI>29)?
The south
Disability adjusted life years due to mental illness are second only to cancer in frequency in the United States
False
Key elements of surveillance include:
a. Timely analysis
b. Dissemination of results
c. Action based on results
d. Accurate diagnosis
e. a., b., and c. above
a,b, and c
Use(s) of surveillance include(s):
a. Monitoring changes in prevalence
b. Monitoring changes in incidence
c. Documenting past clinical disease
d. All of the above
e. a. and b. above
a and b
The most commonly used study design for conducting surveillance is: a. Cohort
b. Cross-sectional survey
c. Serial cross-sectional surveys
d. Ecologic
e. Nested case-control
serial-cross sectional surveys
The U.S. Morbidity and Mortality Weekly Report uses which kind of surveillance?
a. Anecdotal
b. Passive
c. Active
d. Voluntary
Passive
Sentinel surveillance can be used for advocacy to stimulate action
True
The following characteristics should be evaluated in assessing quality of surveillance:
a. Sensitivity
b. Flexibility
c. Clinically accurate diagnosis
d. All of the above
e. a. and b. above
a and b
The "predictive value positive" is:
a. The proportion of persons testing positive who truly have the disease
b. The proportion of persons with the disease who were tested
c. The proportion of persons with the factor who test positive
d. The proportion of
a
To assess the extent of the current epidemic of HIV/AIDS surveillance systems should identify:
a. Persons with current clinical AIDS
b. Persons with current HIV infection
c. Persons previously infected with HIV
d. Recovered AIDS cases
b
Very detailed figures and graphs should be used to stimulate action by decision makers:
a. True b. False
false